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Once only the province of cheap, seedy hotels, today's junkies are shooting up in living rooms, public bathrooms, in affluent shopping malls and nice restaurants. Users are young and old, and everyone in between. They're overdosing on heroin, on pain pills and opioids, on synthetic drugs better left in operating rooms or with veterinarians. Often, users don't even know what their doses are laced with, and that their hits are tens, or hundreds of times, stronger than heroin alone. As a result, drug users across the country are overdosing at a skyrocketing rate.
Law enforcement officers, treatment centers and medical examiners across the country are scrambling to respond to the surge of heroin and opioid addiction, as well as the drug's increased and toxic potency. Meanwhile, people of all ages continue to overdose to the point of death, or near death – and Oakland County is no exception.
Heroin is an equal opportunity destroyer, Oakland County Sheriff Michael Bouchard pointed out. "No one out there reading should presume 'I live in a certain community and it won't happen here.' It happens to the most economically challenged areas and the most prosperous. It happens to all races, and all creeds."
Although heroin use is nothing new, synthetic opioids are appearing in toxicology tests at potency levels rarely, if ever, seen before.
Fentanyl, a short-acting synthetic opioid that is approved by the U.S. Food and Drug Administration (FDA) and is 80 times as potent as morphine, is ordinarily used in hospitals for anesthesia, or by physicians to treat chronic pain. But illicit fentanyl is being produced in clandestine laboratories and mixed with or substituted for heroin and sold to addicts who don't know any differently. It is packaged in pills disguised as other less potent opioids, and cut with other drugs, such as cocaine. When taken other than as prescribed, fentanyl can suppress breathing up to the point of death.
According to the Drug Enforcement Administration (DEA), at least 12 different analogs of fentanyl – substances with a similar chemical structure to fentanyl – have been identified in the U.S. drug traffic industry. Similar drugs that have shown up recently include U47700, U50488, both opioid powders, furanyl fentanyl, and carfentanil – which is 10,000 times more potent than morphine and typically administered by veterinarians to tranquilize large animals such as elephants.
"The (testing) labs are being overwhelmed. They're seeing what they call designer opioids," said Cindi Arfken, professor at Wayne State University in the department of psychiatry and behavioral neurosciences. "Most of the opioids being seized are testing for fentanyl, (but) very few are (identified as) carfentanil." Part of the problem in accurately identifying which opioid is in a substance is simply the logistics of conducting tests for substances not usually seen by medical examiners. But despite the challenges with testing, the Michigan Department of Health and Human Services declared in October that in the four months prior there had been 19 overdose deaths in Wayne County presumed to be linked to carfentanil....continued on page 2